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Bob Tyson is a tall, lean and handsome medical device sales manager with a soft Southern drawl and the lanky clean-cut looks I think of as "early American collegiate." So when he sweetly asks permission to sit in as Ottawa laser and cosmetic medicine specialist Dr. Karen Dover assesses my mummy tummy — which I can’t lose despite countless crunches and thousands of kilometres clocked on my runners — it’s a blow to my ego.

True, it would never work between us — he lives in North Carolina, has a French bombshell girlfriend and has never met me before in his life — but this isn’t how any fantasy date would go. Ever.

I’ve never had my soft underbelly called "just great", but even so, I’m prepared to do just about anything short of surgery to be rid of it, including volunteering to try the treatment in the interest of research. And I’m not alone.

Although Canada’s overweight and obese demographic continues to bulge, there are still 40 per cent of us — according to Statistics Canada — who stay fit, eat well and are close to their ideal weight. Yet as we step into our middle years, there are often pockets of resistant fat around bellies, love handles, girdles and hips, regardless of diet and exercise. Not exactly health-threatening, perhaps, but discouraging all the same.

Enter Zeltiq, Liposonix, Ultrashape and a whole new generation of non-invasive body-sculpting developments aimed at giving nature a nudge.

"These things do not replace good diet and exercise and are not a panacea for obesity," says Dover, who is one of Canada’s first seven Zeltiq practitioners. "Yet all the dieting in the world doesn’t seem to impact on these problem areas. This is more about bringing the body in line with the effort put into staying healthy."

The science is appealing enough. Unlike tummy tucks and liposuction, which carry the risk of infection, blood lipid uptake, embolisms and a painful recovery, non-invasive body sculpting uses cold, heat or ultrasound to target and diminish fat cells, which are later metabolized as waste.

Zeltiq, Ultrashape and Liposonix have been approved by Health Canada for non-invasive fat layer reduction and they await FDA approval in the U.S.) The techniques — which produce results over time, rather than immediately — are markedly different. Ultrashape and Liposonix, which are widely available across Canada and cost up to $2,500 a treatment, use high-intensity ultrasound to target subcutaneous adipose fat. Unlike a low-frequency laser, it can penetrate 2.5 centimetres beneath the skin to emulsify and melt fat, eventually reducing waist circumference by an average 2.8 cm, or one dress size.

But there are downsides.

Ultrasound can’t target small areas, and it can be painful with temporary side effects, including redness, bruising and mild burns, discomfort and swelling.

"These technologies can destroy any tissue and absolutely melt fat and it works," observes Dr. Jay Burns, one of North America’s most respected plastic surgeons and an early adopter of some non-invasive techniques. "Some of the safety concerns about burning skin and elevated lipid (blood fat) levels in blood are not going to be insurmountable."

Increasingly, he says patients in his Dallas office who don’t need liposuction but have problem areas are asking for Zeltiq, which can cost between $700 and $1,000 per one-hour cycle. Patients usually require several cycles.

Zeltiq is considered by some to be a revolutionary technology. Based on the discovery of cryolipolysis by two Harvard University researchers, Zeltiq uses precisely controlled cooling rather than heat. Because fat is far more susceptible to cold than is muscle or skin, cryolipolysis quickly causes apoptosis or programmed cell death in the fat alone, leaving surrounding tissues and muscle intact. As the cells enter apoptosis, the body’s scavenger-like macrophages initiate a defence mechanism and carry away the dead cells.

Slowly, over the course of two to four months, the resistant fat disappears, and is metabolized as waste through the liver. Unlike more invasive techniques like liposuction and abdominoplasty, there is no downtime. In a recently completed multi-centre study of 341 patients, Burns consistently found an average fat loss of 25 per cent and no side effects.

And as I discover, the procedure itself is not painful, although it is initially a bit uncomfortable. My fatty tissue (otherwise known as mummy tummy) is slowly pulled into a plastic suction cup, where two plates chill it. Aside from the initial cold and a tugging sensation, the whole treatment lives up to its "non-invasive" tag.

"Patients work on their laptops, read a book or watch the football game," says Burns. "The only painful thing is spending the time it takes to do it."

Each cycle takes an hour and because of the suction cup size, only a certain amount of fatty tissue can be treated at once. Patients might require several cycles to target stomach fat.

Immediately after the treatment, my mummy tummy is numb, cold and disconcertingly like chicken fat. Still, I later noticed few side effects, which were minimal and included a bit of tenderness, disconcerting numbness, and mild aches and pains that disappeared within a week.

"The chilling action takes advantage of the natural vulnerability of fat to cold," explains Dover. "The fat is crystallized and broken down, and is eventually consumed without any impact on the liver or heart function, short or long term. What is long term is the result. It’ll work on anyone, but we’ll see the quickest and most obvious results on someone who is reasonably fit and close to their ideal weight."

And I can back her up: Within four weeks, I’ve noticed a visible reduction in my mummy tummy, a more comfortable fit in my low-cut jeans and an overall smoother appearance. I’m thrilled and can’t wait to see what the final results will look like in another month.

Although relatively new, the technology has already earned a reputation among plastic surgeons as a positive tool in their kit, says Dr. Jason Pozner, a leading practitioner in Boca Raton who was so impressed with Zeltiq that he released a video of himself using the machine on YouTube.

"I love this device. Unlike most things, it has very consistent results," he says. "Liposuction can remove more fat per session, but there is downtime and possible complications. This has neither."

And while "surgery is still the gold standard, and will deliver the best results you’ll ever get," adds Burns, non-invasive technology is increasingly gaining favour among patients who wouldn’t traditionally consider liposuction or other procedures.

"When you can do something that doesn’t create much downtime and has predictable results, no matter what it is, there is a market for that," he says.

"My feeling is that people will always want a magic wand, and so we are obliged to find it."

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